Dr. Makary is one of the good ones. This is from before the pandemic. But it needs to be discussed as healthcare has been becoming more and more fascist ever since the implementation of Medicare. Dr. Makary does a lot of pro bono expert testimony for patients. One of my favorite lines he says that he uses at these courthouses… “I can’t mow your lawn and then charge you $50,000 without a contract.” The point being that patients sign a consent to treat when they were vulnerable. Where is the spirit of medicine? Where is the mission of the hospital? Where is the charter for the hospital? He and his team will then read the charters in court. Really good listen. The 18 minute mark is a good starting point for the above referenced part.
I listened to another in-depth interview him with was very good. He talked about a study by a cardio specialist who pretended to be a patient and called 100 hospitals trying to figure out how much it would cost for a bypass surgery. They didn’t want to answer. He eventually hounded 50 of them to give him prices, which ranged from something like 7k to 40k …for the same procedure. And there appeared to be no correlation between price and perceived quality. Indeed, any market system with such secret variable pricing should be expected to be inefficient.
Yup, as I’ve said for years on here that your medical doctors are the only service provider you’ll ever have who can’t tell you and don’t know what their basic services will cost. It’s a morass of codes and contracts that are different for each of us. Unlike even your dentist or eye doctor. The “insurance” part of health coverage insures you don’t go broke, not that you get quality health care at affordable prices. We’ve completely lost sight of what it's supposed to be.
And then you have crap like this where large networks and insurance companies play a game of chicken over who gets to rob us more while the citizens and business owners of an entire state hold their collective breath. There aren't enough adjectives to describe how dumb our employer based, middleman run healthcare is.
Certainly its should be easy to get prices for a test or "routine" procedure. The issue is when a "routine" procedure becomes non routine. A CABG is far from routine all kinds of crap can go wrong, and every patient isn't an optimum specimen to begin with. It's not like doing an oil change on your truck.
Not to mention that you can't bring your truck to a mechanic, have no means to pay, but the mechanic be legally required to provide services, anyway.
This is true, but in other situations where services are so complex that the exact work cannot always be known in advance, providers offer estimates. This is clearly what the 50 hospitals that did respond were offering.
This is why the issue is so complex. It is not a simple fix for sure. But we have to figure out how to simplify and be more transparent. The body is way too complex to make it simple. From a medical side. My grandfather should have been sent home to hospice a decade ago. Instead he spent 6 weeks of misery at Osceola Regional Medical Center (get out of that place the second you are stable). After two weeks he should have been out of there and been treated with dignity from home with hospice care. Instead doctors would come in a few times a day and bill out the code for a visit. Very similar situation for my wife’s grandmother though the length of time in the hospital was much shorter. But the 30 second stop by to bill a code was apparent. I do not know the answer. But just a shift to transparency would be huge. We had a patient who had a very expensive treatment plan. There was an even more expensive treatment plan they could have done. And a cheaper one. Going in they knew there was a chance of failure. And sure enough a little over a year in there was a failure. So we could have just moved on and provided the cheap way and expensive way and charged our bill. But we credited the amount spent to the expensive option even though we did not have to. End of the day we probably did not make any money on the extra needed treatment. But that was fine.
Or is it? Michigan man Sergio Enrique Diaz-Navarro sued after Jeep kills mechanic Jeffrey Hawkins during oil change
Americans are just fine with the status quo and are afraid of change. If they weren't they'd be pushing for Washington to change things
Not sure I see it that way. Americans want change. The problem is that they all want it 100% "their way" or nothing at all. So, nothing ever changes because no one can compromise any more.
Yep. And I don't know what the answer is this side of some kind of universal care. Note: I don't want to hijack the threads with the pros and cons of universal care. My question is 'what else is the answer?'
There is no other answer. You can't go free market for a number of reasons - which is why we have the middle-man model. This clearly is broken as well. If someone has a forth option, I'm all ears, but I haven't heard one, yet.
You’re absolutely correct. The pressure on physicians to bill is enormous. I’m friends with several doctors who lament the state of our system. None of them were in the $1,000,000.00 base salary category. I also represented the business office of one hospital and one large clinic. It was extremely rare that we didn’t negotiate downward, and substantially, with both patients themselves and third party payors. I became very disillusioned over the years. (Don’t tell anyone I told you this.)
This was a pretty good read on how other countries are trying to figure it out, what works and what is flawed: 9 things Americans need to learn from the rest of the world’s health care systems
Actually, universal healthcare IS the answer. How is it that the United States, the purportedly greatest and richest country in the World, doesn’t provide to all of its citizens? Shouldn’t we be spending money ensuring we have basic health care, instead of building walls, or paying billions to people to NOT WORK? Sure, the insurance lobby hates the idea (although I don’t see why there can’t be additional health insurance to cover concierge medicine). So, too, the ultra powerful pharmaceutical lobby, who wants to protect their huge margins. Yes, the issues are complicated and solutions complex. But why not try to get bipartisan participation to create a workable, sustainable, universal healthcare system in this Great Country????